GigAcademy Course Registration & Intake Form
Use this form to sign up for guitar or piano
Students Full Name
First Name
Last Name
Age
Student Grade (if applicable)
Parent Guardian Name (if student is under 18)
First Name
Last Name
Relationship to Student
Contact Information
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Preferred Method of Communication
Phone
Text
Email
Emergency Contact
Emergency Contact Name
First Name
Last Name
Relationship to Student
Emergency Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Musical Background
Which instrumental course are you interested in taking?
Piano
Guitar
Have you ever taken piano or guitar lessons?
Yes
No
If yes: How many years?
Can you currently read music?
Yes
A little
No
Can you play by ear?
Yes
Somewhat
No
Do you play any other instruments?
Piano
Voice
Guitar
Drums
Bass
Strings
Woodwinds
Brass
Other
Current Skill Level (Choose one)
Complete Beginner
Beginner
Early Intermediate
Intermediate
Advanced
Unsure
Musical Interest
What styles of music interest you?
Gospel
Classical
Jazz
Pop
R&B
Worship
Blues
Contemporary Christian
Other
Learning Goals
What would you like to accomplish?
Play songs by ear
Read sheet music
Improve technique
Learn chords
Play in church
Songwriting
Music theory
Other
Instrument Availability
Do you have access to a instrument at home?
Acoustic Piano
Keyboard
Acoustic Guitar
Electric Guitar
No Instrument Yet
Medical/Accessibility Information
Is there anything the instructor should know to help provide the best learning environment?
Photo & Video Permission
I give GigAcadamy permission to use photos or videos of lessons or performances for promotional purposes.
Yes
No
Additional Comments
Anything else you'd like us to know?
Student Signature
Parent/Guardian Signature (if under 18)
Date
-
Month
-
Day
Year
Date
Continue
Continue
Should be Empty: